Surviving Mental Illnesses
Mental illness is so challenging for everyone, not just the client. The family, friends and the therapist are all involved with the client, the symptoms, the good, the bad and the ugly. Many psychiatrists do not spend hours with patients anymore, understanding them, their symptoms, coming up with proper diagnosis and treatments. Now the system is dysfunctional and the psychiatrists goes by the therapist’s recommendations and prescribes medication according to the therapist’s treatment plan, session notes and recommendations. That’s what they do, 15 minutes with a patient in these overbooked clinics for the poor, disabled and the mentally ill that can’t afford a private doctor. The therapists are fresh out of school. Filled with dreams of helping people and making a difference but with 80-100 cases and just a half an hour to 45 mins every week or other week they see how the mentally ill are treated and they see the problems with the system but they’re young, inexperienced, overworked, underpaid and frustrated. The burnout rates can be high especially in busy inner city clinics who need their youth, their new insight and passion. After months of seeing how the system works therapists leave and get other jobs and sometimes in completely different fields.
From a patient’s point of view, I feel the same frustration. I’m on an assembly line and a lab rat. Try this combination, oh you had suicidal thoughts and ideations? Let’s increase your dose 50 mgs. Fortunately I didn’t take it and walked away. Finding a psychiatrist that could help me with my bipolar disorder, anxiety disorder, PTSD and panic attacks was no easy task because I am disabled and on medicare and medicaid so I had to go to a clinic. In two years I have had 5 different therapists at two different clinics because the therapists leave their jobs just as progress and trust were building and we were starting to make progress. Then like a good little rat, I get back in my wheel and start running and working hard, wanting so bad to get better but just as I get to that point were I’m not circling around and around going nowhere, things start to smooth out and become clear again. Progress begins, things start to get better and my therapist informs me that they’re leaving. I get back in my wheel again.
I am in a new clinic now. I’ve been there for a few months now. It’s still an assembly line but with a great therapist and some insight I am now making real progress. What’s different now? My way of viewing the situation. If I break my leg a doctor puts a cast on it and 6 weeks later all better. With behavioral and psychological problems its not so easy. The brain is so complex full of chemical reactions that affect our behaviors and thought patterns but we’ve barely scratched the surface of understanding the brain. When painful experiences are expressed in disordered thinking and behaviors they can be diagnosed and in a perfect setting might be treated with the right medications and live a quality of life they didn’t have before.
Human beings are unique and our responses and behaviors are unique, our thoughts and the way we view our environment. Mental illness cannot be treated the same way with each patient the way a broken leg can because the patient has to work towards change. If the patient isn’t taught how to change they will continue to suffer. Change is a terrifying concept to a mentally ill patient. Once trust is established and progress is being made it is a delicate relationship and to uproot it before the patient is ready can have severe consequences and the mentally ill get trapped in a system that fails them over and over.
The mentally ill are difficult to deal with. Therapists hear horrible stories and know the “why” it’s the “how” that is so hard. If there isn’t enough time to figure out the “how” and get the patient to begin to take steps towards change then the cycles will continue. Our current treatments are not working. The structure, the caseloads, the burnout rates and the compensation are not nurturing to patients or the therapists that work with them.
Being on both sides of the fence I know what it’s like to go home and worry about a patient or client. It is very hard to learn how to leave the cases at work without hardening your heart. I know for me, I have to work harder then ever to establish report with my therapist and get to work. The clock is ticking before I have to get back on the wheel and the only way to stop it is to beat it with change. Such a big scary word but the true path to surviving mental illness.